Hertfordshire Partnership NHS Trust was recently fined £150,000 following the fatal stabbing of a care worker in a Dunstable care home.

Care worker Kathleen Bainbridge was killed by a resident at Abacus House care home and another care worker who came to her rescue also sustained minor injuries. The resident, Stephen Flatt, was known to be suffering from bipolar disorder and had been placed at the home by the Trust despite the fact that care staff had no expertise or training in how to manage violent behaviour or deal with bipolar disorder.

The Trust was convicted under Section 3 of the Health and Safety at Work etc Act 1974 after an eight-week trial in Luton Crown Court. Section 3 requires employers to conduct their business, so far as is reasonably practicable, so that non-employees are not exposed to risks to their health and safety. By deciding to place the Mr Flatt into an inappropriate care home, the Trust had breached its duty to him and also those responsible for his care. In addition to the fine of £150,000, the Trust was also ordered to pay costs of £326,346.

The owner of the Abacus House, Mr Menna, was found guilty of breaching Section 2 and 3 of the 1974 Act. Section 2 imposes a duty on employers to ensure, as far as reasonably practicable, the health, safety and welfare of employees. It was established by the Court that Mr Menna had not been honest with the Trust when they enquired about the home’s ability to cater for the needs of those with bipolar disorder. In addition, by failing to identify the risks posed by Mr Flatt, the care home had failed in its duty to its employees (the care workers) and non-employees (Mr Flatt). For these breaches, Mr Menna was fined £75,000 plus £338,996 in costs.

Failure to properly assess and communicate the needs of care home residents was a theme common to another recent prosecution heard in Shrewsbury Crown Court this month. The Hartlands Rest Home was fined £100,000 after an elderly resident had a fatal fall whilst shopping. The resident, Joan Moore had walked to the shops with the help of a carer and using a wheeled walking frame. This was despite the requirements of Ms Moore’s written care plan, which required her to be transported in a wheelchair outside of the home following a history of falls.

The subsequent investigation found that staff typically relied on verbal instructions from management as to any care requirements, rather than the written care plan.

The corporate owner of the care home, D Roche Limited, was convicted of offences under Section 3 of the 1974 Act and Regulation 3 of the Management of Health and Safety at Work Regulations 1999. A £50,000 fine was imposed for each offence together with costs of £5,479.

The two cases above remind those responsible for patients that their needs come first. Detailed assessments should be conducted so that the best possible care can be provided and, crucially, that assessment needs to be communicated to, and followed, by those delivering the care on a day-to-day basis.